All
nurses delegate tasks while at work. Some guidelines are provided in the article
to direct you in the process of delegating, including the five rights of
delegation. The subject of responsibility for delegated tasks to unlicensed
assistive personnel (UAPs) is discussed. Signs to success in delegation is
overviewed. The issue of trust and leadership skills is touched upon.

Today
as a nurse, it seems like there is so much to do, so little time to do it, and
more added to your workload every day. Thank goodness there are unlicensed
assistive personnel (UAPs) to help out with those simple, yet time-consuming
tasks that must be done daily. Knowing what all UAPs are capable of doing and to
what extent is very important. Thatís where the issue of delegation comes in -
an ongoing topic in nursing leadership and management. All nurses delegate tasks
while at work, and may not even realize it. Just asking a UAP to assist in
feeding, bathing, or other activities of daily living helps save time
tremendously, and is considered a daily delegation task. Clearly defined, the
generally recognized definition of nursing delegation is entrusting the
performance of a selected nursing task to an individual who is qualified,
competent, and able to perform such tasks (Habgood, 2000).

There
are some guidelines to direct you in the process of delegating. These five
rights include: the right task for the individual to perform; the right
circumstance for the patient to receive the care; the right person to perform
the care for the patient; the right information to describe desired patient
outcomes; and the right supervision to ensure the task is carried out safely
(Cohen, 2000). When you have concluded that all of these components are in
place, then you are ready to delegate. Your hospitalís policies and the UAPs
job description determine the type of tasks you may delegate as well. It is
important to read them frequently, as job descriptions may change over time. You
should talk with the UAPs and ask what tasks they can perform, make sure they
understand what you asked them to do, and be specific when you delegate tasks to
them. You need to develop a trusting relationship with the UAPs you work with,
making it clear that they can only accept assignments within the parameters of
their training and experience, and be honest if they are unable to do an
assignment (Fisher, 2000). This openness will probably provoke a pleasant
atmosphere, and the UAPs may even become more willing to assist and share their
needs with you, the nurse.

Nurses
remain responsible for any and all delegated tasks. Inappropriate delegation may
lead to liability claims against the nurse, disciplinary actions, or license
revocation. Nurses must supervise UAPs while they are performing these tasks to
ensure adequate resources to support, direct, and evaluate the activity
(Sheehan, 2001). The nurse is responsible for all care provided to a patient by
the UAP, and the nurse is accountable if the task is not completed or done
properly, so it is important to follow up on the assigned tasks (Ahmed, 2000).
No one wants to lose their nursing license over a delegated task, so it may be a
good idea to double-check as you give patients medicines or treatments and
assess them. According to Palmier, UAPs need to be assigned to a nurse, not to
patients or to tasks, as they are to be under the supervision or direction of a
registered nurse. The most cost-effective care belongs to a single person-a RN,
who requires less supervision, and reduces costs through shorter lengths of stay
and decreased mortality rates (1998). As a result of managed care and budget
constraints, the use of UAPs have increased at a startling rate, as they are
performing increasingly complex tasks, and RNs, in turn, are undertaking
increased responsibility for supervising the care UAPs provide (Habgood, 2000).
As the UAPís supervisor, you should know what they can and cannot do, and
assign only those tasks you know they can perform competently. Before delegating
any tasks, you should assess each patient to determine whether the care to be
provided should be assigned to a UAP or performed by an RN (Brown, 1999). Even
though the UAPs provide a great deal of help, it may seem just as time-consuming
to check that they completed their tasks efficiently and review their
competencies. Overall, UAPs are an important aspect to the medical team and
cannot be overlooked.

There
are several signs that you have been successful at delegating, which may include
confidence among staff, updated job descriptions, annual staff competency
process, and a staff that is educated on delegation and individual
accountability (Cohen, 2000). Delegation is an on-going topic that is enhanced
everyday with practice and patience, and you cannot expect to be perfect when
starting out. Nor can you expect the UAPs to do a task as you would yourself.
When evaluating the individual's performance, don't give low marks just because
they didn't do it the same way you would have, praise the employee if it was
completed correctly. As you gain trust and learn the strengths of your
employees, you can increase the difficulty of the tasks you delegate (Puetz
& Thomas, 1998).

In
conclusion, entrusting others will only enhance the care of patients, so we must
take advantage of what they have to offer that contributes to the provision of
healthcare. Those who have experience and self-confidence to delegate
comfortably will need to be role models for the less experienced nurses as they
gain confidence in their ability to delegate tasks (Patton, 2001). Delegation
strategies incorporated into practice can provide the RN with more time for
professional nursing roles, and enhance job satisfaction in the areas of
decision-making and promotional opportunity (Parsons, 1998). The skills
pertinent to a manager also apply to a delegator, as a delegator needs to learn
and acquire leadership skills that empower others, establish a direction, align
people, motivate and inspire, encourage self-observation and self-evaluation,
and are generous in their use of questions to their staff and verbal rewards (Palmier,
1998). The skills of delegating can be kept with you and enhanced over your
lifetime, and even help you grow professionally. The delegated task may be
small, but has a large overall impact for all involved.